Diabetes and Peripheral Arterial Disease
What are the vascular health risks if you have diabetes type 1 or type 2?
The vascular health risks associated with diabetes are all related to the development of atherosclerosis. When you develop atherosclerosis, it is in the end arteries of organs and limbs. Diabetics are prone to getting amputations of their toes and fingers because of plaque that develops in their arms and legs. Renal failure in diabetics occurs because of plaque that develops in their kidneys. They can go blind due to retinopathy caused by plaque that develops in the arteries in their eyes. Atherosclerosis in diabetics can cause a whole host of organ injuries as well as threaten their limbs.
What is the connection between diabetes and Peripheral Arterial Disease?
The connection between diabetes and Peripheral Arterial Disease (PAD) is such that when diabetic patients have increased glucose levels, or hyperglycemia, circulating in their blood, they are prone to developing atherosclerosis. Once they start forming plaque related to atherosclerotic disease, there is decreased blood flow to the feet, toes, hands, and fingers as well. This can cause wounds that are very difficult to heal, and ulcers that just won’t go away, which leads to systemic and bone infections. This can ultimately require amputation.
If you manage your diabetes, are you still at risk for vascular diseases like Peripheral Arterial Disease (PAD)?
Effective management of diabetes is crucial in trying to prevent PAD. Certainly, diabetics can develop PAD even when their sugars are kept in line, as can non-diabetics. There are a lot of other factors that can contribute to developing PAD, such as high blood pressure and high cholesterol. Controlling blood sugar levels is very important. This will help prevent serious complications such as developing wounds and blockages in the arteries that provide blood flow to the extremities. It is also very important to continue to get screening tests such as ankle-brachial indices and ultrasounds to confirm there are no developing blockages that can potentially be treated before they become something more serious.
How can patients care for diabetic foot wounds to help prevent future amputation?
One of the most important things for patients with diabetes is to practice proper foot hygiene and foot care. Working hand in hand with our podiatrists helps to get a good evaluation of their feet by ordering the appropriate screening tests and consulting for proper foot care. As a diabetic, it’s very important to be evaluated at least annually to exclude any potential serious risk factors for developing wounds that are very difficult to heal or symptoms such as neuropathy or foot pain that may be secondary to the lack of blood flow. Foot care is especially important for diabetics, and it needs to involve our podiatry colleagues, be proactive, and be completed annually to ensure close monitoring and effective management.
Can Peripheral Arterial Disease cause wounds to heal slower?
Peripheral Arterial Disease can cause wounds to heal slower. The whole healing process for a wound relies on the area of the wound receiving adequate blood flow. When there are blockages, areas of narrowing, or stenosis in the arteries providing blood to the region that has a wound, those wounds won’t heal effectively. Any treatments such as IV antibiotics won’t reach the areas that are infected appropriately. Those wounds can take a very long time to heal if they heal at all. One of the other issues is because these wounds don’t heal and are prolonged in nature, the infections can get deeper and deeper, involving the bones and becoming systemic. Knowing that the blood flow to a wound is adequate is crucial because if it’s not, we can improve the blood flow to the area and be a lot more aggressive in trying to get these wounds to heal.
What is the biggest risk factor for Peripheral Arterial Disease?
There are multiple risk factors for developing Peripheral Arterial Disease. One of the most common, in terms of the highest risks, is diabetes. There are also other comorbid conditions, such as high blood pressure and hypercholesterolemia, that can all lead to the development of atherosclerosis and peripheral arterial disease.
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